Impact of HCV infection on first cadaveric renal transplantation, a single center experience

Hsin Hung Lin, Chiu Ching Huang, Jeng Yi Huang, Chih Wei Yang, Mai Szu Wu, Ji Tseng Fang, Chun Chen Yu, Yang Jen Chiang, Sheng Hsieh Chu

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Controversy still persists regarding the impact of HCV infection on renal transplant recipients. This study aimed to evaluate the effect of anti-HCV antibody status on patients and grafts of renal transplants at a single center. Methods: We examined 299 first cadaveric renal transplants performed between July 1981 and May 2000 at our hospital, including 129 patients with anti-HCV antibody positive (HCV+ group) and 170 patients with anti-HCV antibody negative (HCV- group). The HBsAg of the 299 patients were all negative throughout the follow-up period. Causes of graft failure and patient death were analyzed. Patient and graft cumulative survival were compared between HCV+ and HCV- groups. Multivariate analysis with Cox proportional hazard model were calculated for risk hazards of outcome. Results: Overall cumulative patient survival was 97.72, 85.63 and 71.31% at 1, 10, and 15 yr, respectively, in the HCV+ group, compared with 95.02, 67.85 and 59.83% at 1, 10 and 15 yr, respectively, in the HCV- group (p = 0.014). The major cause of patient death in both groups was infection with 26.67% in HCV + group and 60.87% in HCV- group. Cumulative graft survival in the HCV+ group revealed 92.26, 55.97 and 26.16% at 1, 10 and 15 yr, respectively, compared with 88.07, 58.34 and 58.32% at 1, 10 and 15 yr, respectively, in the HCV- group (p = 0.700). The major cause of graft failure was chronic allograft dysfunction (56.82%) in HCV+ group, and patient death (32.43%) in the HCV- group. Multivariate analysis of patient survival revealed anti-HCV antibody+ had lesser risk hazard (aRR: 0.30, p = 0.002), chronic hepatitis had higher risk hazard (aRR: 1.90, p = 0.135), male recipient had higher risk hazard (aRR: 2.18, p = 0.051), and older recipients (age > 55) also had higher risk hazard (aRR: 4.21, p = 0.063). Analysis of graft survival revealed only older donors (age > 35) had higher risk hazard (aRR: 1.90, p = 0.081). Conclusions: The study revealed that patients with anti-HCV antibody had higher incidence of chronic hepatitis, chronic allograft dysfunction and post-transplantation nephrotic syndrome. Graft survival tended lower in the very long time. However, patients with anti-HCV antibodies had better patient survival when compared with patients without HCV antibodies up to 15 yr follow up. Patients of hepatitis C group without clinical chronic hepatitis was associated with best patient survival.

Original languageEnglish
Pages (from-to)261-266
Number of pages6
JournalClinical Transplantation
Volume18
Issue number3
DOIs
Publication statusPublished - Jun 2004
Externally publishedYes

Keywords

  • Hepatitis C virus
  • Renal transplantation

ASJC Scopus subject areas

  • Transplantation
  • Immunology

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